Abstract: A dialysis catheter including a first portion having a first diameter, an elongated distal portion having a second smaller diameter, and a transition portion The first portion includes first and second independent blood withdrawal lumens extending in the first portion, the first withdrawal lumen terminating in the transition portion in a first terminal opening and the second withdrawal lumen terminating in a second terminal opening, the first and second terminal openings being radially spaced and axially adjacent. A longitudinally extending blood delivery lumen extends in the first portion and terminates in a delivery opening in the distal portion of the catheter, the first and second terminal openings positioned proximally of the delivery opening and each of the first and second terminal openings having a curved wall surrounding a portion of the terminal opening.

Abstract: The present invention relates to a catheter for realizing a volume flow into or out of a human or animal organ, comprising a catheter tube and, at a distance from the distal end of the catheter, an affixing device for mechanically affixing the catheter in the tissue of a human or animal organ.

Abstract: A catheter assembly comprises a catheter having a distal end and a longitudinal axis, a stent disposed about the distal end of the catheter, and a stent protector. The stent protector has a stent covering portion disposed about the stent and a catheter engagement portion that removably engages the stent protector to the catheter assembly. The stent covering portion is disposed about the stent without substantially engaging the stent.

Abstract: The invention relates to a trocar sleeve or trocar and a trocar tip for minimally invasive/endoscopic surgical procedures carried out on people or animals. The trocar sleeve here has holding means in order to prevent the device from slipping out during the operation.

Abstract: A surgical access port for passage through body tissue to provide access to an underlying tissue site is provided. The access port has a working channel dimensioned for receiving a surgical instrument and a seal assembly for providing a substantial seal before, during and after insertion of a surgical instrument. The seal assembly includes an instrument seal and a zero seal. The instrument seal includes a proximal base that is interconnected to a distal instrument engaging portion by an elongate supporting portion. The engaging portion has a lateral dimension larger than the lateral dimension of the supporting portion forming a bulbous, mushroom-like head. The lateral dimension of the engaging portion decreases toward a distal opening of the instrument seal such that the distal end of the engaging portion is substantially perpendicular to the seal axis. The supporting portion closely conforms to an inserted instrument and serves to align the distal end of the seal.

Abstract: Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

Abstract: An introducer and method provides a surgical tool with a pathway through tissue to a surgical site, wherein the surgical tool includes at least one surgical instrument. The introducer comprises a flexible sheath having a distal portion including a distal end and is arranged for receiving the surgical tool. A tissue separation tip at the distal portion of the sheath advances the sheath into the tissue towards the surgical site. The tissue separation tip is arranged to form a tissue gap and provide the at least one surgical instrument access to the tissue gap for performing a medical procedure consonant with the formation of the tissue gap or the performance of work at the surgical site.

Abstract: A permanent reversible acute occlusion implantable device and method are described for immediate occlusion of a body lumen, such as the fallopian tubes of the human female, but which can be reopened when necessary at a later date.

Abstract: Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

Abstract: Devices and methods for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having chronic obstructive pulmonary disease. The methods and devices create channels in lung tissue and maintain the patency of these surgically created channels in tissue. Maintaining the patency of the channels allows air to pass directly out of the lung tissue which facilitates the exchange of oxygen ultimately into the blood and/or decompresses hyper-inflated lungs.

Abstract: A catheter with an improved retaining, activation and locking features is provided which is a safe device with reduced irritation and discomfort for a patient. The retaining mechanism positioned at the proximal end of the catheter assumes a “closed” position for introduction and removal of the catheter into and from the body cavity of a patient, and is transitioned into the “open” position when the catheter is positioned within the body cavity by mechanically manipulating the retaining mechanism through an activation mechanism having a piston member slideably displaceable within a cylinder housing member. A locking mechanism is included for maintaining the catheter in the “open” position.

Abstract: A treatment method on tissues in a body cavity includes: a first step of forming a hole for communicating first body tissue with second body tissue while both are in close contact with each other; and a second step of endoscopically inserting a treatment device into the second body tissue through the hole.

Abstract: A treatment device is provided including a catheter having a lumen that is opened to a distal end of the catheter; a wire passing through the lumen so that the wire is inserted into or retracted from the lumen; and a piece disposed at a distal end of the wire and having the maximum width when the piece is protruded from the distal end of the catheter is set larger than the diameter of the lumen, wherein the piece body is formed of a deformable material having a broad curved surface shape that distributes concentration of pressure acting on tissues, and when the wire is pulled in toward the catheter, the piece being extended in the axial direction by the lumen and reduced in its outer diameter so as to be pulled into the lumen.

Abstract: An introducer assembly that may be employed to implant a medical device includes an introducer shaft, and an anchor sleeve and a deployment tool mounted on the shaft. According to some methods, the sleeve is deployed onto an elongate body of the medical device, after the body has been advanced through a lumen of the introducer shaft and to an implant site within a body of a patient, by pulling the introducer shaft proximally, out from the body of the patient, while holding the deployment tool in place, relative to the advanced body of the device.

Abstract: A surgical access port for passage through body tissue to provide access to an underlying tissue site is provided. The access port has a working channel dimensioned for receiving a surgical instrument and a seal assembly for providing a substantial seal before, during and after insertion of a surgical instrument. The seal assembly includes an instrument seal and a zero seal. The instrument seal includes a proximal base that is interconnected to a distal instrument engaging portion by an elongate supporting portion. The engaging portion has a lateral dimension larger than the lateral dimension of the supporting portion forming a bulbous, mushroom-like head. The lateral dimension of the engaging portion decreases toward a distal opening of the instrument seal such that the distal end of the engaging portion is substantially perpendicular to the seal axis. The supporting portion closely conforms to an inserted instrument and serves to align the distal end of the seal.

Abstract: A catheter grip and catheter assembly are provided. The catheter grip includes a body portion adapted to extend circumferentially around a catheter shaft of the catheter assembly to facilitate gripping of the catheter shaft by a user. The catheter grip also includes a head portion through which the catheter shaft can be fed and a biasing mechanism. The biasing mechanism biases the body portion and the head portion away from one another.

Abstract: A catheter that distributes bipolar radiofrequency for use during the percutaneous ablation of cardiac arrhythmias. The catheter comprising a flexible sheath, a handle, a pull-wire, holes for irrigation in its distal tip, sensing means and electrodes.

Abstract: A liquid catheter, in particular a urinary catheter, includes a catheter shaft part (21) with a longitudinal liquid channel extending between a proximal and distal side thereof, and an anchoring body (22). The catheter body is intended to be received fully internally in a body cavity, such as in particular the urine bladder (50), and to drain the bladder from inside via the urethra (51). The catheter body has a length to span a distance between the bladder and a closure point (35) of the sphincter urethra. An operating member (24,25) is connected durably to the catheter body to enable a user to carry the catheter body transluminally out of the bladder past the closure point. An insertion device for the catheter includes an insertion sleeve which can be carried transluminally as far as the urine bladder and from which the catheter body can be carried into the bladder.

Abstract: A configurable percutaneous endoscopic gastrostomy tube includes a shaft having a distal end and a proximal end. The shaft defines a lumen therethrough for passage of a feeding solution or medicine. An expandable retainer is located on the shaft, the retainer having a deployed position and an insertion position. The tube includes a releasable lock for maintaining the expandable retainer in its deployed position, the releasable lock located on the shaft proximal to the expandable retainer. A flexible sheath surrounds the expandable retainer, the sheath being generally loose around the retainer when the retainer is in an insertion position and the sheath being generally snug against an exterior surface of the retainer when the retainer is in a deployed position.

Abstract: A spinal intervertebral support implant, for fusion or for dynamic stabilization purposes. A rod, preferably in the form of a screw, is inserted obliquely from the pedicle of an inferior vertebra into the body of a neighboring superior vertebra, through the disc space. The rod can be anchored into the body of the superior vertebra by means of a force fit or a screw thread. A pile of elements is disposed on the rod in the disc space like a pile of washers, so that the compression load between vertebrae is carried partly by these elements. These elements can be inserted through the bore through which the rod was inserted in a tightly folded configuration, and deployed into their washer-like form only when in position in the intervertebral space, such that there is no need for any additional incisions.

Abstract: Braid-balls suitable for aneurysm occlusion and/or parent vessel occlusion/sacrifice (e.g., in treating neurovascular defects) are disclosed. Especially for aneurysm treatment, but also for either one of the aforementioned treatments, the form of the ball is very important. In particular, the density of the device is paramount in applications where braid itself is intended to moderate or stop blood flow—allowing thrombosis within a volume formed by the ball.

Abstract: A medical device for removing a material from a hollow anatomical structure is provided. The device includes a radially expandable capture member. The device includes a treatment segment that is positioned distally of the capture member in use and having at least one exit port adapted for delivering a fluid agent to the material. The device includes an embolic capture device that is positioned distally of the treatment segment in use and including a radially expandable filter for capturing a part of the material which travels downstream of the treatment segment. Additionally, a method is provided herein for infusing, injecting, distributing, or releasing an intended fluid into a hollow anatomical structure.

Abstract: Disrupting tissue and devices and systems for disrupting tissue. The disclosure describes ways to deliver moieties to a target tissue, where the target tissue in general is not at the point of introduction, in such a way that minimal damage is produced in the tissue at the point of introduction. In some embodiments this is accomplished by jetting fluid at high velocity into the target tissue. The disclosure further describes novel agents deliverable in such systems for use in remodeling tissues. Some of these agents comprise a liquid while others do not. Additionally, although not specifically described in detail much of the disclosure may additionally be used in the delivery of therapeutic drugs.

Abstract: Catheter assemblies, kits and methods allowing for the drainage or administration of fluid or small particles are disclosed. A catheter assembly can include a shaft with a lumen, an expandable retention member, an elongate actuation member and a locking mechanism. The expandable retention member can be positioned at a shaft distal end portion and can include one or more filaments forming a plurality of drainage or administration interstices of variable or uniform size. The elongate actuation member can include an actuation member distal end, directly or indirectly engaged with the expandable retention member, and an actuation member proximal end. Movement of the actuation member proximal end relative to a proximal end of the shaft can cause the expandable retention member to change from a lower-profile configuration to a higher-profile configuration. A moved position of the elongate actuation member can be secured by rotating, sliding or otherwise manipulating the locking mechanism.

Abstract: Systems and methods are provided for performing a medical procedure within a patient's body that involves a thoracic duct including an ostium communicating with the patient's venous system. An apparatus is provided that includes a catheter including proximal and distal ends and a lumen extending therebetween. An expandable sealing member is carried beyond the distal end that is expandable from a delivery condition to a deployed condition in which the sealing member defines a concave contact surface shaped for engaging a vessel wall surrounding the outlet of the thoracic duct. The sealing member includes an aspiration port in the contact surface communicating with the catheter lumen for removing fluid from the thoracic duct.

Abstract: An embolic capturing device for capturing emboli within a body lumen is disclosed. The embolic capturing device (10) comprises a filtering basket (20) and at least one coil (22) attached to the basket. The filtering basket includes a frame (23) and a filtering body (30) disposed on the frame. The at least one coil is attached to the filtering body for filtering emboli in the body lumen.

Abstract: A vena cava filter catheter includes a catheter having a lumen disposed therethrough and at least one strand of biocompatible wire. The at least one strand has a first state in which the at least one strand has an elongate geometry suitable for traversing the lumen of the catheter and a second state in which the at least one strand assumes a pre-set geometry in which the at least one strand assumes a tortuous configuration adapted to occupy a space approximating a luminal diameter of an inferior vena cava.

Abstract: A catheter for the local delivery of therapeutic agents and methods of using the same for the treatment or prevention of disease are disclosed. A catheter may include a tubular net and a guidewire attached to the tubular net longitudinally along the abluminal side of the net. The catheter may further include a tubular member that opens onto the abluminal side of the tubular net.

Abstract: A medical device can be used to drain fluids from the body during a medical procedure that requires the insertion of a medical instrument into an anatomical lumen or cavity. The device generally allows the simultaneous introduction of the medical instrument into the body and drainage of fluid out of the body during a medical procedure.

Abstract: A needleless fluid injection device including a flexible shaft with a proximal end, a distal end, an injection lumen extending from the proximal end to the distal end of the shaft, and at least one injection orifice extending through a wall of the injection lumen at the distal end of the shaft. The injection lumen can include a depth-limiting system (462) at its distal end for controlling the depth of insertion of the injection lumen relative to a target tissue of a patient. The injection lumen can alternatively or additionally include at least one guidance feature. The injection lumen can alternatively or additionally include at least one flow-modifying protrusion extending from the inner tubular wall of the injection lumen and toward a longitudinal axis of the injection lumen.

Abstract: A medical device is provided for dilatation of a vessel and delivery of a therapeutic agent to a wall of the vessel. The medical device comprises a catheter, a balloon located at a distal end of the catheter, and a drug delivery extension. The drug delivery extension is configured to extend beyond an outer surface of the balloon when the balloon is in an expanded configuration in order to deliver the therapeutic agent to an area beyond the outer surface of the balloon. The drug delivery extension may be one or more tubes, elongate members and/or expandable structures. The drug delivery extension may include a sheath for drug delivery.

Abstract: Medical devices which are adapted to be inserted into a patient for a limited period of time using minimally invasive insertion procedures for dilating a stenotic opening, such as a stenotic sinus opening, are provided. The devices and methods can be used for treating sinusitis and other nasal and/or sinus disorders.

Abstract: Embodiments of the present invention provide a nastogastric tube for deflecting an esophagus during an ablation procedure. According to one embodiment, the nasogastric tube includes a tube comprising at least one lumen having proximal and distal ends, and an esophageal deflector positioned within the at least one lumen and configured to deflect a portion of the tube between the proximal and distal ends. The esophageal deflector is configured to deflect the portion of the tube proximate to a retrocardiac portion of the esophagus such that the retrocardiac portion of the esophagus is deflected away from an ablation site.

Abstract: An intravascular aspirating assembly comprising an elongate guidewire having a proximally facing filter disposed on a distal portion thereof, a single operator exchange aspiration catheter disposed on the guidewire, the aspiration catheter having a proximal end, a distal end and an aspiration lumen extending therebetween, an extension catheter slidably disposed in the aspiration lumen and having a length greater than that of the aspiration catheter.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A series of medical instruments can be made with the use of shape memory tube with a transformation temperature that is above or below the ambient temperature. In the first case, the material behaves with the shape memory effect and in the second case the behavior is superelastic. The wall of the tube has been provided with a plurality of slots in specific places, often near or at the distal end of the instrument, and in specific arrangements which allow local variations in diameter, shape, and/or length. These variations can either be caused by the memory effect during temperature change or by superelastic behavior during change of the mechanical influences on the memory metal by the surrounding material.

Abstract: The invention relates generally to medical devices and methods for the treatment of ocular disorders. One method provides an implant having an inlet portion with a first anchor and an outlet portion with a second anchor. The implant is implanted in tissue of an eye such the implant conducts fluid from an anterior chamber of the eye to a physiological outflow pathway of the eye. The implanting involves positioning the first anchor adjacent eye tissue, positioning the second anchor within the physiological outflow pathway, and deploying the second anchor such that the second anchor secures the implant within the physiological outflow pathway and a distal end of the second anchor is positioned further into the physiological outflow pathway than an outlet of the outlet portion.

Abstract: An intravascular device can comprise a carrier and an expansion apparatus. The device can be used for intravascular treatment of atherosclerotic plaque. The carrier can be reversibly expandable and collapsible within a vessel and can have ribbon strips extending between opposite ends in a longitudinal direction of the carrier. The ribbon strips can each be formed with a plurality of elongated protrusions thereon. The expansion apparatus can be used to actuate the ribbon strips each with the plurality elongated protrusions to pierce a luminal surface of the plaque with lines or patterns of microperforations which act as serrations for forming cleavage lines or planes in the plaque.

Abstract: The present invention provides a gastrostomy or jejunal device for extended insertion into an abdomen of a patient. The device includes a catheter and a coaxial sheath that surrounds the catheter. The sheath includes a plurality of curved or oblique slots through the sheath materials that form a plurality of arms. A rotatable actuation device is provided to twist the sheath along its longitudinal axis which places the arms in compression and causes them to buckle radially outward beyond the circumference of the remainder of the sheath when the actuation device is rotated with respect to the remainder of the device.

Abstract: Therapeutic device intended for the selective cytoreductive treatment of an obstruction in a natural lumen or passage of the human or animal body, said lumen being obstructed by the effect of a local cell proliferation, said device comprising a tubular element, in particular of cylindrical shape, intended to be placed in said natural lumen and sufficiently flexible to conform to said natural lumen, but sufficiently rigid to maintain an artificial channel in said lumen. The tubular element supports lengthwise a medicinal sleeve which is intended to come into line with, and into contact with, the obstruction once the natural lumen has been intubated, and is designed to deliver locally, at least in its outer surface portion, at least one therapeutic agent which is cytoreductive, in particular cytotoxic, through contact with the cells under whose effect said lumen is obstructed.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A series of medical instruments can be made with the use of shape memory tube with a transformation temperature that is above or below the ambient temperature. In the first case, the material behaves with the shape memory effect and in the second case the behavior is superelastic. The wall of the tube has been provided with a plurality of slots in specific places, often near or at the distal end of the instrument, and in specific arrangements which allow local variations in diameter, shape, and/or length. These variations can either be caused by the memory effect during temperature change or by superelastic behavior during change of the mechanical influences on the memory metal by the surrounding material.

Abstract: Methods are disclosed for the providing oxygenated blood to venous circulation. Embodiments include a femoral access approach to the creation of an Aorta-caval fistula at the bifurcation of the Aorta and the Inferior Vena Cava; an apparatus for the creation, modification and maintenance of a fistula; and a method of supplying oxygenated blood to the venous circulation of a patient. The devices, systems and methods can be used to treat patients with one or more numerous ailments including chronic obstructive pulmonary disease, congestive heart failure, hypertension, hypotension, respiratory failure, pulmonary arterial hypertension, lung fibrosis and adult respiratory distress syndrome.

Abstract: A catheter delivers an electrode within a vein for a minimally invasive treatment of varicose veins and venous insufficiency using RF energy. The catheter is introduced into a patient and positioned within the section of the vein to be treated. The electrode radiates high frequency energy towards the vein, and the surrounding venous tissue becomes heated and begins to shrink. The catheter includes a controllable member for limiting the amount of shrinkage of the vein to the diameter of the member. The electrode remains active until there has been sufficient shrinkage of the vein. The extent of shrinkage of the vein may be detected by fluoroscopy. After treating one section of the vein, the catheter and the electrode can be repositioned intraluminally within the vein to treat different sections of the vein until all desired venous sections and valves are repaired and rendered functionally competent.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A manually manipulatable tool for removing a fecal impaction, the tool is adapted for insertion into a patient's rectum to engage and penetrate the impaction. The tool is fitted with flexible, arcuately configured elements collapsible at least partially during insertion into the rectum and penetration of the fecal impaction, withdrawal of the tool deploying the elements to exert traction on the impaction thus facilitating withdrawal of at least portions of the impaction. A body member of the tool is preferably elongated and can optionally be provided with a longitudinally extending lumen for introduction of an enema solution concurrently with or independently of impaction removal.